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===Natural History===
===Natural History===
*The symptoms of ovarian germ cell tumors usually develop in the teenage years with abdominal pain or fullness, and palpable pelvic/abdominal mass.<ref name="LowIlancheran2012">{{cite journal|last1=Low|first1=Jeffrey J.H.|last2=Ilancheran|first2=Arunachalam|last3=Ng|first3=Joseph S.|title=Malignant ovarian germ-cell tumours|journal=Best Practice & Research Clinical Obstetrics & Gynaecology|volume=26|issue=3|year=2012|pages=347–355|issn=15216934|doi=10.1016/j.bpobgyn.2012.01.002}}</ref>
*The symptoms of ovarian germ cell tumors usually develop in the teenage years with abdominal pain or fullness, and palpable pelvic/abdominal mass.<ref name="LowIlancheran2012">{{cite journal|last1=Low|first1=Jeffrey J.H.|last2=Ilancheran|first2=Arunachalam|last3=Ng|first3=Joseph S.|title=Malignant ovarian germ-cell tumours|journal=Best Practice & Research Clinical Obstetrics & Gynaecology|volume=26|issue=3|year=2012|pages=347–355|issn=15216934|doi=10.1016/j.bpobgyn.2012.01.002}}</ref>
*Dysgerminomas tends to spread late and do so through lymphatic system primarily.<ref name="ShaabanRezvani2014">{{cite journal|last1=Shaaban|first1=Akram M.|last2=Rezvani|first2=Maryam|last3=Elsayes|first3=Khaled M.|last4=Baskin|first4=Henry|last5=Mourad|first5=Amr|last6=Foster|first6=Bryan R.|last7=Jarboe|first7=Elke A.|last8=Menias|first8=Christine O.|title=Ovarian Malignant Germ Cell Tumors: Cellular Classification and Clinical and Imaging Features|journal=RadioGraphics|volume=34|issue=3|year=2014|pages=777–801|issn=0271-5333|doi=10.1148/rg.343130067}}</ref>
*Yolk sac tumor tends to grow rapidly and spread to abdominopelvic cavity in early stages.<ref name="SteinWasnik2017">{{cite journal|last1=Stein|first1=Erica B.|last2=Wasnik|first2=Ashish P.|last3=Sciallis|first3=Andrew P.|last4=Kamaya|first4=Aya|last5=Maturen|first5=Katherine E.|title=MR Imaging–Pathologic Correlation in Ovarian Cancer|journal=Magnetic Resonance Imaging Clinics of North America|volume=25|issue=3|year=2017|pages=545–562|issn=10649689|doi=10.1016/j.mric.2017.03.004}}</ref>
*Yolk sac tumor tends to grow rapidly and spread to abdominopelvic cavity in early stages.<ref name="SteinWasnik2017">{{cite journal|last1=Stein|first1=Erica B.|last2=Wasnik|first2=Ashish P.|last3=Sciallis|first3=Andrew P.|last4=Kamaya|first4=Aya|last5=Maturen|first5=Katherine E.|title=MR Imaging–Pathologic Correlation in Ovarian Cancer|journal=Magnetic Resonance Imaging Clinics of North America|volume=25|issue=3|year=2017|pages=545–562|issn=10649689|doi=10.1016/j.mric.2017.03.004}}</ref>
*Yolk sac tumor mostly affects women in theie second or third decade of life.<ref name="pmid63318">{{cite journal |vauthors=Kurman RJ, Norris HJ |title=Endodermal sinus tumor of the ovary: a clinical and pathologic analysis of 71 cases |journal=Cancer |volume=38 |issue=6 |pages=2404–19 |date=December 1976 |pmid=63318 |doi= |url=}}</ref>
*Yolk sac tumor mostly affects women in theie second or third decade of life.<ref name="pmid63318">{{cite journal |vauthors=Kurman RJ, Norris HJ |title=Endodermal sinus tumor of the ovary: a clinical and pathologic analysis of 71 cases |journal=Cancer |volume=38 |issue=6 |pages=2404–19 |date=December 1976 |pmid=63318 |doi= |url=}}</ref>
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*The presence of [characteristic of disease] is associated with a particularly [good/poor] prognosis among patients with [disease/malignancy].
*The presence of [characteristic of disease] is associated with a particularly [good/poor] prognosis among patients with [disease/malignancy].
*[Subtype of disease/malignancy] is associated with the most favorable prognosis.
*[Subtype of disease/malignancy] is associated with the most favorable prognosis.
*The prognosis varies with the [characteristic] of tumor; [subtype of disease/malignancy] have the most favorable prognosis.
*The prognosis varies with the [characteristic] of the tumor; [subtype of disease/malignancy] have the most favorable prognosis.
===Dysgerminoma===
===Dysgerminoma===
*Depending on the stage of the tumor at the time of diagnosis, the prognosis may vary. However, the prognosis is generally regarded as good.<ref name="VicusBeiner2010">{{cite journal|last1=Vicus|first1=Danielle|last2=Beiner|first2=Mario E.|last3=Klachook|first3=Shany|last4=Le|first4=Lisa W.|last5=Laframboise|first5=Stephane|last6=Mackay|first6=Helen|title=Pure dysgerminoma of the ovary 35 years on: A single institutional experience|journal=Gynecologic Oncology|volume=117|issue=1|year=2010|pages=23–26|issn=00908258|doi=10.1016/j.ygyno.2009.12.024}}</ref>
*Depending on the stage of the tumor at the time of diagnosis, the prognosis may vary. However, the prognosis is generally regarded as good.<ref name="VicusBeiner2010">{{cite journal|last1=Vicus|first1=Danielle|last2=Beiner|first2=Mario E.|last3=Klachook|first3=Shany|last4=Le|first4=Lisa W.|last5=Laframboise|first5=Stephane|last6=Mackay|first6=Helen|title=Pure dysgerminoma of the ovary 35 years on: A single institutional experience|journal=Gynecologic Oncology|volume=117|issue=1|year=2010|pages=23–26|issn=00908258|doi=10.1016/j.ygyno.2009.12.024}}</ref>
*The 5-year survival rate of the patient even with disseminated disease at the time of diagnosis is above 90%.
*The 5-year survival rate of the patient even with disseminated disease at the time of diagnosis is above 90%.
*Reoccurence of the tumor may occur within 2-years of diagnosis and is curable.
*Reoccurence of the tumor may occur within 2-years of diagnosis and is curable.
**For stage A1 the reocurrence rate is approximately 20% in 2-years.
**For stage A1 the recurrence rate is approximately 20% in 2-years.
===Yolk sac tumor===
*These tumors are highly malignant and tend to spread early.<ref name="ChenRuiz2003">{{cite journal|last1=Chen|first1=Vivien W.|last2=Ruiz|first2=Bernardo|last3=Killeen|first3=Jeffrey L.|last4=Cot�|first4=Timothy R.|last5=Wu|first5=Xiao Cheng|last6=Correa|first6=Catherine N.|last7=Howe|first7=Holly L.|title=Pathology and classification of ovarian tumors|journal=Cancer|volume=97|issue=S10|year=2003|pages=2631–2642|issn=0008-543X|doi=10.1002/cncr.11345}}</ref>
*They usually invade the surrounding structure and within the abdominopelvic cavity.
*They can also metastasize through the lymphatic system.
===Embryonal carcinoma===
*These tumors tend to metastasize early.<ref name="ChenRuiz2003">{{cite journal|last1=Chen|first1=Vivien W.|last2=Ruiz|first2=Bernardo|last3=Killeen|first3=Jeffrey L.|last4=Cot�|first4=Timothy R.|last5=Wu|first5=Xiao Cheng|last6=Correa|first6=Catherine N.|last7=Howe|first7=Holly L.|title=Pathology and classification of ovarian tumors|journal=Cancer|volume=97|issue=S10|year=2003|pages=2631–2642|issn=0008-543X|doi=10.1002/cncr.11345}}</ref>
*They spread through the lymphatic system.
===Choriocarcinoma===
*These tumors are highly malignant and tend to spread locally and within the abdominal cavity.<ref name="ChenRuiz2003">{{cite journal|last1=Chen|first1=Vivien W.|last2=Ruiz|first2=Bernardo|last3=Killeen|first3=Jeffrey L.|last4=Cot�|first4=Timothy R.|last5=Wu|first5=Xiao Cheng|last6=Correa|first6=Catherine N.|last7=Howe|first7=Holly L.|title=Pathology and classification of ovarian tumors|journal=Cancer|volume=97|issue=S10|year=2003|pages=2631–2642|issn=0008-543X|doi=10.1002/cncr.11345}}</ref>
*They spread early in the course of the tumor.


==References==
==References==

Revision as of 17:56, 4 March 2019

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Sahar Memar Montazerin, M.D.[2]

Overview

The prognosis of germ cells of the ovary depends on the type of the tumor and its malignant potentials. Possible complications of benign teratomas are a rupture and ovarian torsion also malignant transformation. If left untreated, [#]% of patients with [disease name] may progress to develop [manifestation 1], [manifestation 2], and [manifestation 3].

OR

Common complications of [disease name] include [complication 1], [complication 2], and [complication 3].

OR

Prognosis is generally excellent/good/poor, and the 1/5/10-year mortality/survival rate of patients with [disease name] is approximately [#]%.

Natural History, Complications, and Prognosis

Natural History

  • The symptoms of ovarian germ cell tumors usually develop in the teenage years with abdominal pain or fullness, and palpable pelvic/abdominal mass.[1]
  • Dysgerminomas tends to spread late and do so through lymphatic system primarily.[2]
  • Yolk sac tumor tends to grow rapidly and spread to abdominopelvic cavity in early stages.[3]
  • Yolk sac tumor mostly affects women in theie second or third decade of life.[4]
  • The symptoms of (disease name) typically develop ___ years after exposure to ___.
  • If left untreated, [#]% of patients with [disease name] may progress to develop [manifestation 1], [manifestation 2], and [manifestation 3].

Complications

Mature teratoma

Common complications of mature teratoma include:[5]

  • Ovarian torsion is the most common complication and affects 5% to 10% of the individuals.
    • It happens at a greater extent in:[6]
      • Younger age (10-19 years)
      • Larger tumors
  • Rupture in < 4% of the affected individuals.[5]
    • Rupture may be associated with leakage of sebaceous contents of the tumor into the peritoneal cavity and leads to granulomatous peritonitis.[7]
      • This complication is very rere and happens in less than 1% of the affected individuals.
  • This tumor may be bilateral in 8% to 15% of cases.
  • Malignant transformation of the tumor may also happen in approximately 2% of affected individuals.[8]
    • The tumor undergoes malignant transformation to squamous cell carcinma in 80% of them and to adenocarcinoma in the rest of the cases.

Dysgerminoma

  • Ovarian torsion and acute abdominal pain may occur in < 10% of the cases.[9]

Prognosis

  • Only 3% to 5% of ovarian germ cell tumors are malignant which the majority include:[10]
    • Dysgerminomas
    • Immature teratomas
    • Yolk sac tumors
      • Pure form
      • Part of a mixed germ cell tumor

Mature teratoma

  • Prognosis is generally excellent in the mature teratoma, but in case of simultaneous malignant transformation, the 5-year survival rate of patients is approximately [15-30]%.[11]
  • The presence of [characteristic of disease] is associated with a particularly [good/poor] prognosis among patients with [disease/malignancy].
  • [Subtype of disease/malignancy] is associated with the most favorable prognosis.
  • The prognosis varies with the [characteristic] of the tumor; [subtype of disease/malignancy] have the most favorable prognosis.

Dysgerminoma

  • Depending on the stage of the tumor at the time of diagnosis, the prognosis may vary. However, the prognosis is generally regarded as good.[12]
  • The 5-year survival rate of the patient even with disseminated disease at the time of diagnosis is above 90%.
  • Reoccurence of the tumor may occur within 2-years of diagnosis and is curable.
    • For stage A1 the recurrence rate is approximately 20% in 2-years.

Yolk sac tumor

  • These tumors are highly malignant and tend to spread early.[13]
  • They usually invade the surrounding structure and within the abdominopelvic cavity.
  • They can also metastasize through the lymphatic system.

Embryonal carcinoma

  • These tumors tend to metastasize early.[13]
  • They spread through the lymphatic system.

Choriocarcinoma

  • These tumors are highly malignant and tend to spread locally and within the abdominal cavity.[13]
  • They spread early in the course of the tumor.

References

  1. ↑ Low, Jeffrey J.H.; Ilancheran, Arunachalam; Ng, Joseph S. (2012). "Malignant ovarian germ-cell tumours". Best Practice & Research Clinical Obstetrics & Gynaecology. 26 (3): 347–355. doi:10.1016/j.bpobgyn.2012.01.002. ISSN 1521-6934.
  2. ↑ Shaaban, Akram M.; Rezvani, Maryam; Elsayes, Khaled M.; Baskin, Henry; Mourad, Amr; Foster, Bryan R.; Jarboe, Elke A.; Menias, Christine O. (2014). "Ovarian Malignant Germ Cell Tumors: Cellular Classification and Clinical and Imaging Features". RadioGraphics. 34 (3): 777–801. doi:10.1148/rg.343130067. ISSN 0271-5333.
  3. ↑ Stein, Erica B.; Wasnik, Ashish P.; Sciallis, Andrew P.; Kamaya, Aya; Maturen, Katherine E. (2017). "MR Imaging–Pathologic Correlation in Ovarian Cancer". Magnetic Resonance Imaging Clinics of North America. 25 (3): 545–562. doi:10.1016/j.mric.2017.03.004. ISSN 1064-9689.
  4. ↑ Kurman RJ, Norris HJ (December 1976). "Endodermal sinus tumor of the ovary: a clinical and pathologic analysis of 71 cases". Cancer. 38 (6): 2404–19. PMID 63318.
  5. ↑ 5.0 5.1 Ayhan, Ali; Bukulmez, Orhan; Genc, Cuneyt; Karamursel, Burcu S.; Ayhan, Ayse (2000). "Mature cystic teratomas of the ovary: case series from one institution over 34 years". European Journal of Obstetrics & Gynecology and Reproductive Biology. 88 (2): 153–157. doi:10.1016/S0301-2115(99)00141-4. ISSN 0301-2115.
  6. ↑ Kim, Min Jae; Kim, Na Young; Lee, Dong-Yun; Yoon, Byung-Koo; Choi, DooSeok (2011). "Clinical characteristics of ovarian teratoma: age-focused retrospective analysis of 580 cases". American Journal of Obstetrics and Gynecology. 205 (1): 32.e1–32.e4. doi:10.1016/j.ajog.2011.02.044. ISSN 0002-9378.
  7. ↑ Comerci JT, Licciardi F, Bergh PA, Gregori C, Breen JL (July 1994). "Mature cystic teratoma: a clinicopathologic evaluation of 517 cases and review of the literature". Obstet Gynecol. 84 (1): 22–8. PMID 8008317.
  8. ↑ Singh P, Yordan EL, Wilbanks GD, Miller AW, Wee A (February 1988). "Malignancy associated with benign cystic teratomas (dermoid cysts) of the ovary". Singapore Med J. 29 (1): 30–4. PMID 2841767.
  9. ↑ A L Husaini H, Soudy H, El Din Darwish A, Ahmed M, Eltigani A, A L Mubarak M, Sabaa AA, Edesa W, A L-Tweigeri T, Al-Badawi IA (December 2012). "Pure dysgerminoma of the ovary: a single institutional experience of 65 patients". Med. Oncol. 29 (4): 2944–8. doi:10.1007/s12032-012-0194-z. PMID 22407668. Vancouver style error: missing comma (help)
  10. ↑ Smith, Harriet O.; Berwick, Marianne; Verschraegen, Claire F.; Wiggins, Charles; Lansing, Letitia; Muller, Carolyn Y.; Qualls, Clifford R. (2006). "Incidence and Survival Rates for Female Malignant Germ Cell Tumors". Obstetrics & Gynecology. 107 (5): 1075–1085. doi:10.1097/01.AOG.0000216004.22588.ce. ISSN 0029-7844.
  11. ↑ Park, Jeong-Yeol; Kim, Dae-Yeon; Kim, Jong-Hyeok; Kim, Yong-Man; Kim, Young-Tak; Nam, Joo-Hyun (2008). "Malignant transformation of mature cystic teratoma of the ovary: Experience at a single institution". European Journal of Obstetrics & Gynecology and Reproductive Biology. 141 (2): 173–178. doi:10.1016/j.ejogrb.2008.07.032. ISSN 0301-2115.
  12. ↑ Vicus, Danielle; Beiner, Mario E.; Klachook, Shany; Le, Lisa W.; Laframboise, Stephane; Mackay, Helen (2010). "Pure dysgerminoma of the ovary 35 years on: A single institutional experience". Gynecologic Oncology. 117 (1): 23–26. doi:10.1016/j.ygyno.2009.12.024. ISSN 0090-8258.
  13. ↑ 13.0 13.1 13.2 Chen, Vivien W.; Ruiz, Bernardo; Killeen, Jeffrey L.; Cot�, Timothy R.; Wu, Xiao Cheng; Correa, Catherine N.; Howe, Holly L. (2003). "Pathology and classification of ovarian tumors". Cancer. 97 (S10): 2631–2642. doi:10.1002/cncr.11345. ISSN 0008-543X. replacement character in |last4= at position 4 (help)
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